de Groot M H, de Winter R F P, van der Plas W, Kerkhof A J F M
Tijdschr Psychiatr. 2016;58(5):351-60.
Multidisciplinary evaluation of suicide cases effectively decreases the suicide rate in mental health care. A new suicide prevention tool (KEHR) can be used in this connection. KEHR has been developed on the basis of the Dutch multidisciplinary practice guideline on the assessment and treatment of suicidal behaviour. The guideline can serve as a frame of reference for the multidisciplinary evaluation of suicide cases. KEHR aims to provide professionals with a better method for preventing suicide.
To describe and evaluate the recently developed KEHR strategy for reducing the number of suicide cases in mental health care.
Naturalistic and observational study. In the course of a year 22 out of 23 suicide cases that had occurred in the pilot institution were evaluated with the help of the KEHR system. Outcomes were discussed with members of multidisciplinary teams. Quantitative and qualitative methods were used in the evaluation process.
Professionals from the main disciplines involved were very willing to use the new tool and were prepared to reflect on their views on the outcomes. The professionals were ready to learn from the suicide cases. Data collected with the tool provided information that can be used to improve guideline adherence. However, the use of KEHR did not lead automatically to the formulation of adjustments and improvements relating to suicidal patients. A specific procedure for improving individual and team performance needs to be developed and tested thoroughly.
KEHR is a promising strategy for improving and enhancing the guideline on the diagnosis and treatment of suicidal behaviour of patients in mental health care. Special procedures need to be developed and studied in order to implement the improvements deemed necessary as a result of the pilot study. The KEHR tool (in the Dutch language) is accessible to mental health care workers after online registration (www.mijnkehr.nl).
对自杀案例进行多学科评估可有效降低精神卫生保健中的自杀率。在此方面可使用一种新的自杀预防工具（KEHR）。KEHR是在荷兰关于自杀行为评估与治疗的多学科实践指南基础上开发的。该指南可作为自杀案例多学科评估的参考框架。KEHR旨在为专业人员提供更好的自杀预防方法。
描述并评估最近开发的KEHR策略，以减少精神卫生保健中的自杀案例数量。
自然主义观察性研究。在一年时间里，试点机构发生的23起自杀案例中有22起借助KEHR系统进行了评估。与多学科团队成员讨论了评估结果。评估过程中采用了定量和定性方法。
主要相关学科的专业人员非常愿意使用这一新工具，并准备反思他们对评估结果的看法。专业人员愿意从自杀案例中吸取教训。用该工具收集的数据提供了可用于提高指南依从性的信息。然而，使用KEHR并不会自动导致针对自杀患者制定调整和改进措施。需要制定并全面测试一种用于提高个人和团队绩效的具体程序。
KEHR是一种有前景的策略，可用于改进和完善精神卫生保健中患者自杀行为诊断与治疗的指南。需要制定并研究特殊程序，以实施因试点研究而认为必要的改进措施。精神卫生保健工作者在在线注册（www.mijnkehr.nl）后即可使用KEHR工具（荷兰语）。
